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Organization
NORTHERN KENTUCKY CONSUMER DIRECTED OPTION PROGRAM
Active
Organization
NORTHERN KENTUCKY CONSUMER DIRECTED OPTION PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY BOSLEY (FINANCE OFFICER)
(859) 283-1885
Entity
Organization
Contact information
Practice address
22 SPIRAL DR, FLORENCE, KY 41042-1300
(859) 283-1885
Mailing address
22 SPIRAL DR, FLORENCE, KY 41042-1300
(859) 283-1885
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33001421
—
KY
Enumeration date
05/12/2008
Last updated
05/06/2015
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